Author(s): Middeldorp S, Meijers JC, van den Ende AE, van Enk A, Bouma BN, et al.
Combined oral contraceptives (OC) are known to increase the risk of venous thromboembolism. The aim of this randomized, cycle-controlled, cross-over study in 28 healthy volunteers was to assess potential differences between the effects of an OC containing 150 microg levonorgestrel (as representative of the so-called second generation OC) and an OC containing 150 microg desogestrel (as representative of the third generation OC) in combination with 30 microg ethinylestradiol on several coagulation factors and markers of thrombin formation. All participants used each OC for two cycles, and were switched to the other OC after a washout period of two menstrual cycles. The plasma concentrations of factors II, VII, X, and fibrinogen significantly increased during use of both the levonorgestrel- and desogestrel-containing OC's. The plasma concentrations of factor VIII increased, and of factor V decreased, changes which only reached statistical significance during the use of the desogestrel-containing OC. During exposure to the desogestrel-containing OC, as compared with the levonorgestrel-containing OC, both factor VII and factor II showed a greater increase (FVII: 32% and 12% respectively; p <0.0001; FII: 16% and 12% respectively; p = 0.048), whereas factor V showed a greater decrease (-11% and -3% respectively; p = 0.010). Only one of the markers for ongoing coagulation (prothrombin fragment 1+2) showed a significant increase during OC use, whereas concentrations of thrombin-antithrombin complexes and soluble fibrin remained unchanged. For these markers, there was no difference between the tested OC's. We conclude that there are differences between the effects of levonorgestrel and desogestrel-containing OC's on some coagulation factors. Whether these changes provide a biological explanation for the reported differences in venous thromboembolic risk is as yet unclear. The real challenge now becomes to define a pattern of changes in the various systems which, if affected simultaneously, may tip the hemostatic balance towards a prethrombotic state and may lead to overt clinical venous thromboembolism.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/10928461
Author(s): Nordström M, Lindblad B, Bergqvist D, Kjellström T
Author(s): Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, et al.
Author(s): Silverstein MD, Heit JA, Mohr DN, Petterson TM, O'Fallon WM, et al.
Author(s): Rosendaal FR
Author(s): MahéI, Caulin C, Bergmann JF
Author(s): MahéI, Caulin C, Bergmann JE
Author(s): Pottier P, Hardouin JB, Lejeune S, Jolliet P, Gillet B, et al.
Author(s): IsmaN, Svensson PJ, Gottsäter A, Lindblad B
Author(s): OuldzeinH, Nourredine A, Cherradi R, Rahal N, Mechmeche R, et al.
Author(s): Healy B, Levin E, Perrin K, Weatherall M, Beasley R
Author(s): Fletcher HM, Wharfe G, Williams NP, Pedican M, Brooks A, et al.
Author(s): Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, et al.
Author(s): Goldhaber SZ, Grodstein F, Stampfer MJ, Manson JE, Colditz GA, et al.
Author(s): Agnelli G
Author(s): Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, et al.
Author(s): BulgerCM, Jacobs C, Patel NH
Author(s): vanHylckamaVliegA, Helmerhorst FM, Vandenbroucke JP, Doggen CJ, Rosendaal FR
Author(s): Lidegaard Ø, Løkkegaard E, Svendsen AL, Agger C
Author(s): Hannaford PC
Author(s): vanHylckamaVlieg A , Middeldorp S
Author(s): Kemmeren JM, Algra A, Grobbee DE
Author(s): Parkin L, Sharples K, Hernandez RK, Jick SS
Author(s): Jick SS, Hernandez RK
Author(s): Kluft C, Lansink M
Author(s): Rosing J, Middeldorp S, Curvers J, Christella M, Thomassen LG, et al.
Author(s): Tans G, Curvers J, Middeldorp S, Thomassen MC, Meijers JC, et al.
Author(s): Alhenc-Gelas M, Plu-Bureau G, Guillonneau S, Kirzin JM, Aiach M, et al.
Author(s): van Vliet HA, Bertina RM, Dahm AE, Rosendaal FR, Rosing J, et al.
Author(s): Odlind V, Milsom I, Persson I, Victor A
Author(s): Wiegratz I, Kutschera E, Lee JH, Moore C, Mellinger U, et al.
Author(s): van Vliet HA, Frolich M, Christella M, Thomassen LG, Doggen CJ, et al.
Author(s): Rad M, Kluft C, Ménard J, Burggraaf J, de Kam ML, et al.
Author(s): Meissner MH, Chandler WL, Elliott JS
Author(s): Benhamou Y, Marie I, David N, Gbaguidi X, Cailleux N, et al.
Author(s): Blom JW, Doggen CJ, Osanto S, Rosendaal FR
Author(s): Anderson FA Jr, Wheeler HB
Author(s): Hankey GJ, Eikelboom JW
Author(s): Prandoni P, Lensing AW, CogoA, Cuppini S, Villalta S, et al.
Author(s): Schulman S, Granqvist S, Holmström M, Carlsson A, Lindmarker P, et al.
Author(s): Hansson PO, Sörbo J, Eriksson H